| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.48 | $126.48 | $126.48 | |
Aetna
| Professional | $126.48 | $126.48 | $169.87 | |
CareFirst
| Professional | $188.00 | $188.00 | $211.25 | |
Cigna
| Professional | $129.03 | $129.03 | $129.03 | |
Kaiser Permanente
| Professional | $200.87 | $200.87 | $613.45 | |
United
| Professional | $102.78 | $154.18 | $231.65 |